Objective To introduce the basic research and cl inical appl ication of stem cells transplantation for treating diabetic foot. Methods The recent original articles about the stem cells transplantation for treating diabetic foot were extensively reviewed. Results Transplanted different stem cells in diabetic foot could enhanced ulceration heal ing in certain conditions, increase neovascularization and avoid amputation. Conclusion Stem cells transplantation for treating diabeticfoot may be a future approach．
Objective To investigate the surgical methods and cl inical results of reconstructing soft tissue defects in dorsum of forefoot with distally based saphenous neurocutaneous flap of lower rotating point. Methods From January 2005 to August 2007, 6 cases of soft tissue defects in dorsum of forefoot, including 4 males and 2 females aged 28-53 years, were treated with the distally based saphenous neurocutaneous flaps of lower rotating point. The soft tissue defect was in left foot in 2 cases and in right foot in 4 cases. Five cases of soft tissue defects were caused by crush, and 1 case was caused by traffic accident. Tendons and bones were exposed in all cases. The defects after debridement were 7.0 cm × 5.0 cm to 9.0 cm × 5.5 cm in size. Emergency operation was performed in 2 cases and selective operation in 4 cases. Rotating point of the flaps was from 1 to 3 cm above medial malleolus. The size of the flaps ranged from 8.0 cm × 6.0 cm to 13.0 cm × 6.5 cm. Neuroanastomosis was performed in 2 cases of the flaps. Skin defects in donor site were repaired with thickness skin graft. Results Four cases of the transferred flaps survived completely and the other 2 cases began to swell and emerge water bl ister from the distant end of the flap after operation, which resulted in distal superficial necrosis of flaps, heal ing was achieved after change dressings and skin grafted. Skin graft in donor site survived completely in all cases. All cases were followed up from 6 to 18 months. The color and texture and thickness of theflaps were similar to reci pient site. Pain sensation and warmth sensation of the 2 flaps whose cutaneous nerve were anastomosed recovered completely, two point discrimination were 8 mm and 9 mm respectively. Sensation and warmth sensation of the 4 flaps whose cutaneous nerve were not anastomosed recovered partly. All patients returned to their normal walking and running activities and no ulceration occurred. No donor site morbidity was encountered. Conclusion Blood supply of the distally based saphenous neurocutaneous flap of lower rotating point is sufficient, the flap is especially useful for repair of soft tissue defects in dorsum of forefoot.
ObjectiveTo compare effect of enterovirus (EV) 71 nucleic acid detection and EV71-IgM antibody detection on clinically diagnosis of hand-foot-mouth disease in children. MethodsRectal swabs collected from 1379 children who were clinically diagnosed from April 20, 2011 to September 10, 2011 as suspected patients with the handfoot- mouth disease were detected by fluorogenic quantitative polymerase chain reaction to conduct EV71 nucleic acid detection. Meantime, enzyme-linked immunosorbent assay was used to conduct EV71-IgM antibody detection in serum samples collected from those children. ResultsIn these 1379 cases, 79 had positive EV71 nucleic acids with a positive rate of 5.73%; while 82 cases had positive EV71-IgM antibodies with a positive rate of 5.95%. There were 32 cases with positive EV71 nucleic acid and positive EV71-IgM antibody. The rate of consistent results of two detection methods was 95.2%. The positive rates of two methods had no negligible differences (χ2=0.093, P=0.761). ConclusionCombination of EV71 nucleic acid detection and EV71-IgM antibody detection, can improve the efficiency in diagnosing hand-foot-mouth disease in children and facilitate the protection and diagnosis of the disease.
ObjectiveTo investigate the clinical therapeutic effect of silver ions dressing for patient with diabetic foot ulcers. MethodsAccording to the diagnostic and classification criteria of diabetes and diabetic foot of World Health Organization (WHO), outpatients and inpatients with diabetic foot ulcers admitted to the Department of Burns and Plastic Surgery of Dazhou Central Hospital from October 2013 to May 2015 were randomly divided into a silver ion dressing treatment group and a traditional dressing treatment group. The effective rate, time of occurrence of granulation tissue, wound healing time and wound area reduction ratio between the two groups were compared by using SPSS17.0 software. ResultsA total of 80 patients were included, of which 40 patients in each group. Compared with the control group, the total effective rate was higher (92.5% vs. 62.5%, P=0.001), the occurrence time of granulation tissue (6.4±0.72 vs. 10.8 ±1.9, P=0.000) and wound healing time (31.3±8.2 vs. 47.4±11.5, P=0.000) were shorter, and the wound area reduction ration was greater (46.3±7.6 vs. 32.6±6.1, P=0.000) in the silver ions dressing group with significant differences. ConclusionThe effects of silver-containing dressings is superior to Vaseline dressing in the treatment of diabetic foot ulcers.
Objective To evaluate the clinical effectiveness of the first metatarsophalangeal (MTP) joint arthroplasty versus arthrodesis for rheumatoid forefoot deformity. Methods The randomized controlled trials (RCTs) about the first MTP joint arthroplasty vs. arthrodesis for rheumatoid forefoot deformity published by February 2012 were searched in the databases such as CNKI, Ovid, MEDLINE, CBM, EMbase, WanFang Data, The Cochrane Library (Issue 1, 2012), and KJEBM. Two reviewers independently screened studies, extracted data, and evaluated the methodological quality according to the inclusion and exclusion criteria. Then meta-analysis was conducted using RevMan 5.1 software. Results A total of 4 RCTs were included. Among total 206 (269 feet) patients involved in, 98 (130 feet) were in the arthroplasty group, while the other 108 (139 feet) were in the arthrodesis group. The results of meta-analysis showed that the arthrodesis group was superior to the arthroplasty group in the footwear (MD=−0.88, 95%CI −1.55 to −0.22, P=0.01), and the alignment (MD=−5.04, 95%CI −8.94 to −1.14, Plt;0.000 01) with significant differences. But there were no significant differences between the two groups in patient satisfaction, metastatic lesions, pain, activity and weight-bearing of Hallux. Conclusion Based on the current studies, arthrodesis is superior to arthroplasty in treating rheumatoid forefoot deformity. For the quality restrictions and possible publication bias of the included studies, more double blind, high quality RCTs are required to further evaluate the effects.
OBJECTIVE: To investigate the clinical effects of the microsurgical treatment for the skin-degloving injury of the whole hand or foot. METHODS: From March 1984 to October 2001, we treated 6 cases of skin-degloving injury of the whole hand and foot. In 2 cases of skin-degloving hands, one was treated with free great omentum transplantation plus skin graft, the other with pedical abdominal S-shaped skin flap as well as mid-thick skin graft. In 4 cases of skin-degloving injury of the foot, 2 cases was repaired with free latissimus dosi musculocutaneous flap, 1 case with distall-based lateral skin flap of the leg and 1 case with free tensor fasciae latae muscle flap. The flap size ranged from 7 cm x 9 cm to 22 cm x 15 cm. One case was operated on the emergency stage, the other 5 cases on the delayed stage. The delayed time ranged from 2 to 14 days with an average of 6.6 days. RESULTS: All the flaps survived. After 1-2 year follow-up, the appearance and function of the hand and the foot were good. CONCLUSION: Microsurgery technique in repairing skin-degloving injury of the whole hand and foot can achieve good results. The keys to success are thorough debridement of the recipient area, appropriate selection of the donor site, good vascular anastomosis and active postoperative rehabilitation.
Objective To investigate the etiological and clinical characteristics of the outbreak of hand-foot-mouth disease (HFMD) in Chengdu in 2008. Methods A retrospective analysis was conducted to investigate 482 children with hand-foot-mouth disease in Chengdu from January to December 2008 in terms of epidemiology and clinical characteristics. Results Among the 482 children, 76.14% of the cases were infants, and male children numbered more than female ones. The proportion in the urban area was higher than that in the rural area. May to July was the peak epidemic period. Skin rash and fever were major clinical manifestations. Three cases were diagnosed as viral encephalitis. Conclusion The incidence of hand-foot-mouth disease is related to age and season. Effective prevention measures and isolated treatment are critical for prevention and therapy.
Objective To explore the clinical effect of the lower rotating point super sural neurocutaneous vascular flap on the repair of the softtissue defects in the ankle and foot. Methods From May 2001 to February 2006, 24 patients with the soft tissue defects in the ankle and foot were treated with the lower rotating point super sural neurocutaneous vascular flaps. Among the patients, 15 had an injury in a traffic accident, 6 were wringedand rolled by a machine, 1 was frostbited in both feet, 2 were burned, 25 had an exposure of the bone and joint. The disease course varied from 3 days to 22 months; 19 patients began their treatment 3-7 days after the injury and 5 patients were treated by an elective operation. The soft tissue defects ranged in area from 22 cm × 12 cm to 28 cm × 12 cm. The flaps ranged in size from 24 cm × 14cm to 30 cm × 14 cm, with a range up to the lower region of the popliteal fossa. The rotating point of the flap could be taken in the region 1-5 cm above thelateral malleolar. The donor site was covered by an intermediate thickness skingraft. Results All the 25 flaps in 24 patients survived with asatisfactory appearance and a good function. The distal skin necrosis occurred in 1 flap, but healing occurred after debridement and intermediate thickness skin grafting. The follow-up for 3 months to 5 years revealed that the patients had a normal gait, the flaps had a good sense and a resistance to wearing, and no ulcer occurred. The two point discrimination of the flap was 5-10 mm. Conclusion The lower rotating point super sural neurocutaneous vascular flap has a good skin quality, a high survival rate, and a large donor skin area. The grafting is easy, without any sacrifice of the major blood vessel; therefore, it is a good donor flap in repairing a large soft tissue defect in the ankle and foot.
Objective To review the progress in clinical and biomechanical study on soft tissue reconstruction of adult-acquired flatfoot deformity (AAFD). Methods The recent original articles of soft tissue repair and tendon transfer for AAFD were extensively reviewed. Results The soft tissue procedures for AAFD can be divided into two components: static restoration of medial column stability and dynamic reconstruction of the posterior tibial tendon. The most important static structure to be repaired for AAFD is the spring ligament. On the other hand, various methods can be used for dynamic reconstruction. The flexor digitorum longus transfer is widely used, but results of biomechanical studies do not support the advantage of this method. For patients having normal function of the posterior tibial muscle, the Cobb procedure may be more suitable. Conclusion The soft tissue reconstruction procedures of AAFD should be chosen individually based on the stage and type of the deformity.
Objective To share the experience of the diagnosis and treatment of children with hand-foot-mouth disease. Methods We retrospectively analyzed 31 children with hand-foot-mouth disease in our hospital from April 2007 to June 2007 in terms of epidemiology, clinical features, treatment and prognosis. Results The average age of the children was 2.8 years, and 20 out of the 31 cases were from nurseries and kindergartens. Eighteen had clear contact history. Typical signs and symptoms, including oral ulcerative herpes and blister-like rash in extremities, were found in all cases. All the children were cured after timely diagnosis and early treatment with ribavirin, without any severe complications. Conclusion Timely treatment based on early diagnosis and considerate care are important for children with hand-foot-mouth disease. Nurseries, kindergartens and primary schools should attach great importance to relevant prophylaxis and isolation. These are essential for reducing the occurrence and prevalence of this disease.